Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Larry Derrell Smith, PA-C

Individual provider Physician Assistant · NPI 1558332650

Mr. Larry Derrell Smith, PA-C is a Physician Assistant in Cottonwood, Arizona. Qualified in 1994, 32 years ago. Practices with Northern Arizona Healthcare Corporation, a 395-clinician group and accepts Medicare assignment. Licensed in Arizona and California.

Years since qualifying
32
Licensed in
AZ, CA
In the registry since
2006
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

340 S Willard St Ste 101
Cottonwood, AZ 86326-4126
Phone: (928) 649-7960
Fax: (928) 634-1117
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 1838 (AZ)
Physician Assistant Taxonomy 363A00000X · Licence PA53072 (CA)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence PA53072 (CA)

Record details

NPI number1558332650
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 28, 2006
Last updated in NPPESJune 19, 2025
Certification dateJune 19, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1994 (32 years in practice)
Group practice Northern Arizona Healthcare Corporation — 395 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

Other providers in Cottonwood